NFKB1 and esophageal ulcer: GERD is believed to develop from an inflammatory process caused by chronic gastroesophageal reflux, which leads to mucosal injury and DNA damage.[45] Inflammatory mediators such as NF-κB are associated with the induction of CDX genes, which play a crucial role in the initiation of Barrett esophagus.[46,47] Bisphosphonate users may develop esophagitis, esophageal erosions, and esophageal ulcers due to direct topical injury.[48] Oral bisphosphonates may be associated with GERD through a common inflammatory process.